Evaluating Trainee Performance and Surgical Safety: A Comparison of Supine and Left Lateral Positioning in Pediatric Laparoscopic Appendectomy.

IF 1.1 4区 医学 Q3 SURGERY
Vaibhav Pandey, Shashi Prakash Mishra, Indra Singh Choudhary, Bhanumurthy Marripati Kaushik, Amit Gupta, Ruchira Nandan
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Abstract

Background: Laparoscopic appendectomy is the preferred treatment for acute appendicitis, offering reduced morbidity and quicker recovery compared with open surgery. The positioning of the patient during surgery can significantly impact both the ergonomics for the surgeon and the operational outcomes. This study compares the conventional supine positioning with an innovative left lateral decubitus approach for surgical efficiency and recovery outcomes. Methods: This prospective, comparative study included 30 pediatric patients undergoing interval appendectomy at the Department of Pediatric Surgery, from October 2023 to March 2024. Patients were randomly assigned to undergo appendectomy either in the traditional supine position (Group A) or a modified left lateral position (Group B). The study measured operative times, complication rates, and surgical outcomes using the modified Objective Structured Assessment of Technical Skills (OSATS). Results: The study consisted of 15 patients in each group, with comparable demographics and baseline characteristics. Group B showed a significant reduction in mean operating time (55.25 ± 3.62 minutes) compared with Group A (62.45 ± 4.15 minutes) (P < .001). There were fewer complications in Group B, with no serosal tears reported compared with a 15.3% incidence in Group A. The modified OSATS scores were higher in Group B, indicating better flow of operation and overall performance. Conclusion: The left lateral positioning in pediatric laparoscopic appendectomy demonstrated a potential to enhance surgical efficiency, reduce operative time, and minimize complications compared with the traditional supine approach. These findings suggest that the left lateral position could be considered a preferable alternative in pediatric appendectomy, particularly beneficial for surgical trainees due to improved ergonomics.

评估学员的表现和手术安全性:小儿腹腔镜阑尾切除术中仰卧位和左侧位的比较。
背景:腹腔镜阑尾切除术是急性阑尾炎的首选治疗方法,与开放手术相比,其发病率低,恢复快。手术中患者的体位对外科医生的人体工程学和手术结果都有很大的影响。本研究比较了传统的仰卧位与创新的左侧侧卧位入路的手术效率和恢复效果。方法:这项前瞻性比较研究纳入了2023年10月至2024年3月在儿科外科接受间隔阑尾切除术的30例儿童患者。患者被随机分配到传统的仰卧位(A组)或改良的左侧卧位(B组)进行阑尾切除术。该研究使用改进的客观结构化技术技能评估(OSATS)测量手术时间、并发症发生率和手术结果。结果:该研究包括每组15例患者,具有可比的人口统计学和基线特征。B组平均手术时间(55.25±3.62 min)较a组(62.45±4.15 min)显著缩短(P < 0.001)。与a组15.3%的发生率相比,B组并发症更少,无浆膜撕裂报告。B组改良OSATS评分更高,表明手术流程和整体表现更好。结论:与传统仰卧位入路相比,小儿腹腔镜阑尾切除术采用左侧卧位可提高手术效率,缩短手术时间,减少并发症。这些研究结果表明,由于改善了人体工程学,左侧位可以被认为是小儿阑尾切除术的一个更好的选择,特别是对外科实习生有益。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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